Heartmate II Patients and CPR

Specialties Cardiac

Published

:redbeatheI would like to know, what do we do if our patient is a Heartmate Pt, and they are unconscious. We don't start CPR right, because it would do more damage.

Has anyone had to deal with these patients or been in this situation.?

Specializes in Critical Care, Cardiac.

Here is some great info on VAD emergencies http://emcrit.org/wee/left-ventricular-assist-devices-lvads/

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Specializes in Emergency/Trauma/Critical Care Nursing.

Just curious, have any of you guys had the opportunity to work with the Heartware Vads yet? I personally thought they were uber-cool (yes I know that's not a real word lol). Goes to show how our modern lifestyles affect the ever-changing field of medicine when you can plug your LVAD into the cigarette lighter of your car! :)

Sent from my SPH-D700 using allnurses.com

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Specializes in CTICU.

Yep, use them pretty regularly now. Outcomes seem slightly better than HM2 for now. It's cool that there is no pump pocket required, so no pump pocket infections/hematomas etc. They are a little less forgiving on anticoagulation than the HM2's. Can't really talk specifics because they are still in trial.

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First question: We check to see if it is a controller problem by listening, if it is replace the controller. If not treat arrhythmia/volume etc. All while someone is calling the mechanical heart team (RNs or engineers) and the surgeons. And only when they say so we do compressions doesn't mean we aren't doing the other parts of ACLS in the mean time.

Second question: When they do well they do great, I can think of one that came in once during the year and a half I have worked on my floor, another 2 that have come in twice and are out boating/riding mopeds. But then there are those that just do terrible and we get a little bit to much exposure to that in the in patient world. We have some awesome cases were it gets them to transplant and then some heart breaking stories that still have left me unsettled since April. Bottom line, its a new field and each new device is getting better and we are learning how to better treat the patients and the device.

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I love that device, if I were to get one it would be the heartware. My patients mom brought in his power stuff for me and had the car charger and I was super entertained, I had heard about it but not see one. Really they can go to AC power with what looks like a laptop cable.

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Specializes in CTICU.

Which pump depends somewhat on patient size, comorbidities, whether they fit trial criteria, how literate they are (Heartware has alarm instructions written on the screen, while Heartmate II has illuminated symbols), how tolerant of anticoagulation they'll be (Heartware tends to need slightly higher INR/PTT), what their LV looks like (Heartware is small and not anchored by anything so can tend to move over time as the heart remodels, and you can get inflow obstruction - so someone with an acute event, or viral CM who is likely to recover more is not the best candidate in our experience. Also, hypertrophics have very thick myocardium and the pump inflow is a fixed length so sometimes cannot reach far enough into the LV cavity to unload it well).

Both pumps have AC and DC (car) adapters, but the batteries last long enough now (6-14 hours) that the patients rarely use the car charger.

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